Impact of Untreated Trauma on PSMD Public Treatment Costs

Impact of Untreated Trauma on the Public Treatment Costs of Persons with Severe Mental Disorder
Updated June 2002

Co-PI: Mary Jane Alexander, Ph.D. Kristine Jones, Ph.D., Jay Yoe, Ph.D., Steve Turner, Ph.D.

PROJECT GOALS

Project aims are to:

1) measure the public treatment costs of PSMD who have trauma histories, and
2) determine what factors influence these costs.

RESEARCH ACTIVITIES AND RESULTS

             Method: Study data files were constructed for a cohort (N=1056) that consisted of members of a class action suit against the State of Maine who were comprehensively assessed, and were Medicaid eligible from 1/96-1/98. Data files consist of Comprehensive Assessment data, Medicaid billable services, including pharmacy claims and State Hospital admissions. State hospital costs have been constructed.
            The members of the study cohort of 1056 people met these criteria: They were 18-64 years of age on January 1, 1996, had a Medicaid identifier between 1996 and 1998, were inpatient at a Maine State Psychiatric Hospital, were class members in a suit against the State of Maine, and had completed a Comprehensive Assessment interview that included questions about physical and sexual abuse. The study data file included Medicaid billable services and manually collected information about the cohort’s State Hospital admissions for the major state hospital usage. State hospital financial information including census, operating costs and physical plant organization were reviewed to develop costs for State Hospital admissions.

Results: Preliminary analyses based only on Medicaid data indicated: Cohort members with a trauma history were less likely to use anti-psychotic medications, to have a legal guardian, or to live in a group home. They were more likely to use counseling, intensive outpatient, partial hospital, residential treatment and detoxification services than those without trauma histories. Their Medicaid costs for acute care services were twice the costs of the group without trauma history. Although total costs were not different for the two groups, we expect the addition of State hospital admissions will increase the total costs for those with trauma histories.

POLICY IMPLICATIONS

There is virtually no information available about the cost burden of trauma. By providing data describing public sector costs in a large service system prior to the introduction of trauma sensitive or specific services, policy makers can be made aware of the cost implications of not recognizing and providing trauma specific treatment services.

INCLUSION OF GENDER/ MINORITY GROUPS

	American Indian or Alaskan Native	Asian or Pacific Islander	Black, not of Hispanic Origin	Hispanic	White, not of Hispanic Origin	Other of Unknown Origin	TOTAL
Female					468		468
Male					588		588
Unknown
TOTAL					1056		1056

PLANS

Data sets will be merged, total costs computed, and univariate and multivariate analyses run to examine the relationship between total treatment cost and trauma history, including trauma and cost relevant covariates.

Presentations:

Center Policy Advisory Board meeting, 2000 - preliminary analysis.
American Public Health Association, 2000.

Entered: 7/2/01
Updated: 6/24/02